Hospital admissions for aortic stenosis in pregnancy in the United States - a thirteen year analysis

Neiberg de Alcantara Lima; Ricardo Lessa de Castro Jr; Cuyler Huffman; Mireya Diaz; Carol Cavalcante de Vasconcelos Lima; Mark Schauer; Silvia Teresa Linares; Thomas A Melgar

Hospital admissions for aortic stenosis in pregnancy in the United States - a thirteen year analysis

Am J Cardiovasc Dis. 2020 Oct 15;10(4):398-404. eCollection 2020.

Authors

Neiberg de Alcantara Lima¹, Ricardo Lessa de Castro Jr¹, Cuyler Huffman², Mireya Diaz², Carol Cavalcante de Vasconcelos Lima³, Mark Schauer¹, Silvia Teresa Linares⁴, Thomas A Melgar⁵

Affiliations

¹ Department of Internal Medicine - Western Michigan University Homer Stryker MD School of Medicine Kalamazoo, MI, USA.
² Department of Statistics - Western Michigan University Homer Stryker MD School of Medicine Kalamazoo, MI, USA.
³ Department of Radiology, Beaumont Hospital Royal Oak, MI, USA.
⁴ Department of Obstetrics and Gynecology - Western Michigan University Homer Stryker MD School of Medicine Kalamazoo, MI, USA.
⁵ Departments of Pediatrics, Adolescent and Internal Medicine, Western Michigan University Homer Stryker MD School of Medicine Kalamazoo, MI, USA.

PMID: 33224590
PMCID: PMC7675167

Abstract

Cardiac disease is still the leading cause of non-pregnancy related maternal morbidity and mortality. Valvular disease is one of the most concerning cardiac conditions in pregnancy. Aortic stenosis (AS) is rare in young populations but deadly complications have been reported in pregnant women. This study is a retrospective review of data from the HCUP-NIS Database from 2002-2014. There were 1108 weighted discharges for both pregnancy and AS. The data contained ten or fewer unweighted discharges with AS in pregnancy that underwent a cardiac intervention: open heart surgery or percutaneous cardiac intervention. Patients who had at least one diagnosis for AS had a greater mean cost per discharge than the comparison groups. No deaths were identified in this group. We found a statistically significant increase in the billing codes for pulmonary hypertension and heart failure. Conditions commonly associated with AS such as atrial arrhythmias, ventricular arrhythmias, diastolic dysfunction, ischemic heart disease and stroke were poorly reported. Our study identified a low incidence of AS and its complications in pregnancy in the USA over our 13-year study period. Even though, the morbidity and mortality are low, it is important that clinicians be aware of this diagnosis due higher costs and risk of complications.

Keywords: Aortic valve stenosis; United States; epidemiology; pregnancy.